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3rd year dentistry > Head and Neck anatomy > Flashcards

Head and Neck anatomy Flashcards

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1
Q

The tissue at the junction between the labial or buccal mucosa and the alveolar mucosa is the…

A

Mucobuccal fold

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2
Q

Name the four suprahyoid muscles

A

Digastric Mylohyoid Stylohyoid Geniohyoid

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3
Q

Name the four infrahyoid muscles

A

Omohyoid Sternohyoid Sternothyroid Thyrohyoid

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4
Q

Which paired muscles unite medially to form the floor of the mouth?

A

mylohyoid

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5
Q

Which muscle group serves to depress the hyoid bone?

A

Infrahyoid muscles

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6
Q

Which muscle group is involved in both elevating the hyoid bone and depressing the mandible?

A

suprahyoid muscles

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7
Q

What are the actions of the suprahyoid muscles?

A

Elevation of hyoid bone and larynx if mandible is stabilised by muscles of mastication

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8
Q

What are the actions of the anterior suprahyoid muscles?

A

Depress mandible and open jaws; mylohyoid forms floor of mouth and helps elevate tongue

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9
Q

Give the clinical applications of an emergency airway

A

The cricothyroid ligament may be pierced by a fine 1mm needle when a patient cannot breathe. An example of when this might happen is anaphylactic shock

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10
Q

Give the clinical applications of osteoma

A

This is a localised mass of bone which is a benign tumour. It may be found on the skull but is slow growing with no symptoms. If necessary it can be removed

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11
Q

Give the clinical applications of multiple myeloma

A

This is a tumour of the bone marrow cells and may also affect the skull

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12
Q

Give the clinical applications of Bells palsy

A

This is a unilateral paralysis of the facial nerve with no known cause

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13
Q

Give the clinical applications of an oro-antral fistula

A

some patients will have just a paperthin wall of bony tissue between their first molar and maxillary sinus. When extracting the first molar it may lead to this being broken and there being communication between the oral cavity and the maxillary sinus. When it closes it is lined with epithelial cells

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14
Q

What are the clinical applications of referred pain from toothache?

A

There may be referred pain from toothache via the trigeminal nerve to the ear

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15
Q

What can cause the veins to fill to the point it is a visible distension?

A

Congestive cardiac failure

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15
Q

What nerve provides sensory innervation of the skin to the angle of the mandible and the ear?

A

The great auricular nerve

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15
Q

What nerve supplies the skin of the anterior triangle?

A

The transverse cervical nerve

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16
Q

What is the clinical relevence of the supraclavicular lymph nodes?

A

Malignant disease in the chest or abdomen can present here. Lymphoma or a systemic illness can cause enlargement of these lymph nodes. When removing, beware of CNxi, test function… can the patient shrug?

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17
Q

Where do the cervical lymph nodes drain?

A

The skin overlying the posterior triangle

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18
Q

Where does the eleventh cranial nerve innervate?

A

supplies motor impulses to the trapezius and SCM

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19
Q

describe an extradural haemorrhage

A

this is the rupture of a middle meningeal vessel (artery in particular) causing a haematoma to form. Over hours this can lead to deterioration of consciousness. It is usually caused by a small skull fracture tearing the artery

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20
Q

describe a subdural haemorrhage

A

If the brain is knocked the cerebral veins could break away from the superior sagittal sinus causing blood to build up in the dura mater and arachnoid mater space. This is most likely to affect older people

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21
Q

describe a subarachnoid haemorrhage

A

this is where a cerebral artery aneurysm ruptures causing blood to enter the CSF. Consciousness is lost fast

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22
Q

What is an afferent nerve?

A

a sensory nerve carrying information from body periphery to brain or spinal cord

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23
what is an efferent nerve?
a motor nerve carrying information away from the brain or spinal cord to body periphery
24
what is the innervation of the trigeminal nerve?
sensory supplies face and head skin, teeth, oral cavity and most general sensation of the tongue motor supplies muscles of mastication and some other cranial muscles
25
what are the sensory divisions of the trigeminal nerve?
ophthalmic, maxillary and mandibular
26
what is the innervation of the facial nerve?
sensory supplies skin around the ear and taste sensation for tongue motor supplies the muscles of facial expression, other cranial muscles, the lacrimal gland as well as submandibular, sublingual and minor salivary glands
27
What is Horners syndrome?
Horners syndrome occurs when there is a lesion somewhere along the pathway of the sympathetic fibres travelling to the head
28
List four signs/symptoms of Horners syndrome...
- Drooping of upper eyelid on affected side - Pupillary constriction on affected side - Loss of sweat gland innervation - Flushed, warm/dry skin due to vasodilation
29
What is trigeminal neuralgia?
It is a neurological condition characterised by episodes of brief, intense facial pain over one of the three areas of distribution of CNV
30
What is the cause of trigeminal neuralgia?
The cause is uncertain
31
What can trigger trigeminal neuralgia?
Touch or a draft of cool air
32
What is Bell's Palsy?
It is unilateral facial paralysis with no known cause
33
What is a potential cause of facial palsy?
A result of the herpes simplex virus
34
What is Parkinsons disease?
It is a neurodegenerative disease more common in the over 50's It involves low levels of dopamine (a neurotransmitter) found in the basal ganglia (area of the brain involved in movement) A hallmark sign of Parkinsons is a degeneration of dopamine neurons in the substantia nigra
35
What is the cause of Parkinsons Disease?
The exact cause is unknown but it is thought to be a combination of genetic and environmental factors
36
What are the symptoms of Parkinsons disease?
Tremor (which is worse when a person is at rest) Slowless of movement Rigidity Postural impairment Non motor symptoms can include cognitive and psychiatric symptoms
37
What causes a drooping eyelid and loss of sweating?
Damage to the sympathetic trunk (Horner's syndrome)
38
What are the symptoms of Horners syndrome?
Drooping eyelid, loss of sweating, flushed/dry skin, constricted pupil
39
Name a symptom of damage to the sympathetic trunk?
constricted pupil, drooping eyelid, loss of sweating
40
What would be a reason for enlarged submandibular lymph nodes?
Disease affecting the oral cavity, nasal cavity or maxillary sinus
41
Name some symptoms of a cavernous sinus thrombosis
Headache presenting as sharp pain around the eyes visual problems High temperature seizures
42
Describe a cavernous sinus thrombosis
Bacteria can pass through the pterygoid venous plexus through the sphenoidal emissary veins to the cavernous sinus. There, bacteria can multiply due to the slow flowing blood. Symptoms often start 5-10 days after developing an infection in the face or skull such as a boil or sinusitis
43
What muscle protrudes the tongue?
genioglossus
44
Which muscle tendon inserts on the coronoid process?
Temporalis
45
A patient presents complianing of pain and swelling in the floor of the mouth, especially at meal times. What is the cause?
Calculi has formed in the submandibular duct. Pain is caused by the secretion of saliva that cannot flow and so pressure builds up
46
where do the submental lymph nodes drain?
Lower teeth, floor of mouth, anterior of tongue
47
Where do the submandibular lymph nodes drain?
Lower molars, upper teeth, nose, anterior forehead, sinuses, submandibular and lingual salivary glands
48
Where do the parotid lymph nodes drain?
Middle and posterior scalp, temple, ear and parotid gland
49
Where do deep cervical lymph nodes drain?
pharynx, tonsils, posterior tongue, hard and soft palate, nasal cavity, thyroid and parathyroid gland
50
where do the superficial cervical lymph nodes drain?
skin of the neck
51
what nerve supplies the mucosa of the oropharynx and nasopharynx?
the glossopharyngeal, CNix
52
what nerve supplies the pharyngeal constrictor muscles?
the vagus nerve (CNx)
53
what nerve supplies the palatoglossus muscle?
CNx
54
what is the nerve type and innervation of CNI?
CNI; olfactory nerve sensory innervates nasal mucosa
55
what is the nerve type and innervation of CNII?
CNII; optic nerve sensory retina of eye (sight)
56
what is the nerve type and innervation of CNIII?
CNIII; occulomotor nerve motor innervates muscles of eye
57
name the nerve, foramen by which it exits the cranial cavity and its function CNI
olfactory nerve cribiform plate of ethmoid bone sense of smell
58
name the nerve, foramen from which it exits the cranial cavity and its function CNII
optic nerve optic canal sense of sight
59
name the nerve, foramen from which it exits the cranial cavity and function CNIII
occulomotor superior orbital fissure motor supply to muscles of the eye
60
name the nerve, foramen from which it exits the skull and the function CNIV
trochlear nerve superior orbital fissure supplys motor function to one muscle of the eye
61
name the nerve, foramen from which it exits the cranail cavity CNV
trigeminal nerve ophthalmic division exits via superior orbital fissure maxillary division via foramen rotundum mandibular division via foramen ovale
62
what are the divisions of the trigeminal nerve?
CNV 1 ophthalmic division CNV 2 maxillary division CNV 3 mandibular division
63
what are the functions of the trigeminal nerve?
general sensation to the face and anterior scalp, the eye, nasal cavity and paranasal sinuses, oral cavity and nasopharynx proprioception related to bite strength supply to muscles of mastication and others derived from the first pharyngeal arch
64
name the nerve, foramen from which it exits the cranial cavity and its function CNVI
Abducens superior orbital fissure abduction of eye
65
name the nerve, foramen from which it exits the cranial cavity and function CNVII
Facial nerve internal acoustic meatus motor supply of muscles of facial expression and other muscles derived from second pharyngeal arch taste sensation for anterior two thirds of the tongue parasympathetic supply of lacrimal, nasal, submandibular, sublingual and minor salivary glands
66
name the nerve, foramen from which it exits the cranial cavity and its function CNVIII
vestibulocochlear internal acoustic meatus hearing and balance
67
name the nerve, foramen from which it exits the cranial cavity and its function CNIX
glossopharyngeal jugular foramen sensory for pharynx. Taste to posterior third of tongue motor supply to stylopharyngeus parasympathetic supply to parotid gland baroreceptors of carotid sinus chemoreceptors of carotid body
68
name the nerve, foramen from which it exits the cranial cavity and its function CNX
vagus nerve jugular foramen sensory to interior of larynx, trachea and oesophagus. Taste from region of epiglottis. Motor to muscles of pharynx and larynx Parasympathetic supply to thoracic and abdominal vicera Baroreceptors of aortic arch. Chemoreceptors of aortic bodies
69
name the nerve, foramen from which it exits the cranial cavity and its function CNXI
Accessory nerve jugular foramen cranial root contributes to vagal function spinal root supplies SCM and trapezius muscles
70
name the nerve, foramen from which it exits the cranial cavity and its function CNXII
hypoglossal neve hypoglossal canal motor supply to intrinsic and extrinsic muscle of the tongue except palatoglossus
71
what areas are innervated by the great auricular nerve?
the ear and angle of the mandible
72
where does the submandibular duct enter the mouth?
Sublingual papilla
73
which nerve is at risk during surgery to the submandibular duct?
the lingual nerve
74
why does laceration to the lib cause excessive bleeding?
Rupture of the inferior labial branch of the facial artery where the left and right sides anastomose
75
which muscle is responsible for protrusion of the mandible?
the lateral pterygoid
76
what nerve has been damaged if someone is unable to raise/shrug their shoulder?
Accessory nerve
77
Which muscle does the accessory nerve supply?
trapezius
78
which bones comprise the zygomatic arch?
the zygomatic bone and the temporal bone
79
what saliva is produced by the submandibular gland?
mixed. Both serous and mucous
80
what saliva is produced by the sublingual salivary gland?
mucous secretion
81
what causes the salivary glands to secrete?
the parasympathetic nervous system
82
what muscle runs from the hyoid bone to the tongue?
hyoglossus
83
what is the action of the hyoglossus muscle?
it depresses the tongue
84
what is the origin and insertion of the genioglossus?
origin; mental spine insertion; fans into tongue
85
what is the action of the genioglossus?
protrudes the tongue
86
what is the origin and insertion of the geniohyoid?
origin; mental spines insertion; hyoid bone lies above mylohyoid
87
What are the branches of the maxillary nerve and where do they pass through?
The maxillary nerve is one of three branches of the trigeminal nerve, it exists the skull through the foramen rotundum. Branches from the pterygopalatine fossa; - zygomatic nerve through zygomatic foramen - nasopalatine nerve through sphenopalatine foramen - posterior superior alveolar neve - greater and lesser palatine nerve - pharyngeal nerve There are also branches from the infraorbital canal; - middle superior alveolar nerve - anterior superior alveolar neve - infraorbital nerve
88
Name the origin, insertion, action and nerve supply for the masseter
- Origin; zygomatic arch - Insertion; lateral border of and angle of mandible - Action; elevates the mandible can be tested by clenching jaws Nerve; masseteric branch of mandibular division of trigeminal nerve
89
Name the origin, insertion, action and nerve of the Temporalis
- Origin; floor of temporal fossa - Insertion; coronoid process and anterior border of ramus - Action; elevates and retracts the mandible Nerve; deep temporal nerve, branches of the mandibular division of the trigeminal Can be tested by clenching teeth and palpating
90
What is the origin, insertion, action and nerve supply of the lateral pterygoid?
- Origin; lateral surface of lateral pterygoid plate - Insertion; anterior border of the condyle and intra-articular discs i) inferior belly attaches to head of condyle ii) superior belly inserts into the intra-articular disc - Action; protrudes and laterally deviates the mandible. Inferior head funcitons with mandibular depressors during opening - Nerve; nerve to lateral pterygoid branch of mandibular division of trigeminal nerve Cannot test through intra/extra oral exam but can test response to resisted movement
91
What is the origin, insertion, action and nerve supply for the medial pterygoid?
-Origin; deep head to the medial surface of the lateral pterygoid plate and superficial head to tuberosity of maxilla Insertion; medial surface of angle of mandible Action; elevation and protrusion of mandible Nerve; nerve to medial pterygoid of mandibular branch of trigeminal nerve cannot test through intra/extra oral exam
92
Describe where the mental foramen is located
- it is located on the anterior surface of the mandible. It transmits the terminal branches of the interior alveolar nerve and mental artery - It is located roughly between the first and second permanent lower premolars - It provides sensory innervation to the buccal soft tissue anterior to the mental foramen, lip, and the chin, and the anterior teeth on that side of the arch
93
What nerve is the mental nerve a branch of?
A branch of the inferior alveolar nerve
94
Describe three differences between a stroke and a facial palsy
\*LA causes palsy on the same side \*Stroke causes palsy on the opposite side \*stroke - can still wrinkle forehead on affected side
95
A dentist causes a facial palsy as a result of an IAN block. The patient has a sore TMJ. How was this palsy caused?
If bone is not hit and the needle passes too far posteriorly, LA is deposited in the parotid gland. The facial nerve runs through it, and due to the dense fascia around the gland, the LA will remain for a long time and cause paralysis of the facial muscles that the nerve innervates
96
Explain why a patient who has had a stroke can still wrinkle their forehead, but a patient with a facial palsy cannot
A) The innervation to the muscles of the upper face originates on both sides of the brain, whereas the innervation to the muscles of the lower face comes from the opposite side of the brain only. B) When the cortex is injured, there’s weakness in the contralateral lower face only. C) When the facial nerve is injured, there’s weakness in the ipsilateral upper and lower face.
97
Give three ways you could manage a patient with a facial palsy
\*Reassure the patient. \*Tell them the sensation will return after a few hours. \*Use an eyepatch to prevent the eye from drying out/protect from dust etc as pt cannot blink \*

3rd year dentistry (16 decks)

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